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Author
Topic: Tobacco & CD4s (Read 16897 times)

I was reading something that claimed that smoking lowers your CD4s, but there weren't any studies mentioned or numbers to back it up. I know a doctor would be a bit biased on the subject - not that I don't trust him, he's great. Do any of you know if that statement is true - tobacco lowering CD4s as well?

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"Love is always patient and kind. It is never jealous. Love is never boastful nor conceited. It is never rude or selfish. It does not take offense and is not resentful. Love takes no pleasure in other people's sins, but delights in the truth. It is always ready to excuse, to trust, to hope, and to endure whatever comes." - 1 Corinthians 13:4-7, adaptation in A Walk To Remember

It's funny you mention this Molten. I'm currently conducting my own Totally Unscientific Study on Smoking and AIDS. Essentially, I smoke in an effort to discover which will kill me first, AIDS, smoking related cancer or another smoking related disease.

The results will be published at my funeral.

But seriously, I have heard of this stuff, and whilst I can't name the study I believe that tobacco use is associated with lower than average CD4 counts. Whatever the case is, smoking is really bad for HIV positive people (and people in general) so we should probably give up.

I guess I could double up on my Lexapro, then take my Wellbutrin and Trazodone. Then maybe I could quit smoking. I quit drinking years ago and I like to smoke so I don't see myself quitting any time soon. I haven't gotten any DUIs smoking. Can't quit everything at one time.

Yes it is ! However some people have nasty side effects with this. I know it doesn't happen a lot but a guy over here dropped dead ( about 1 year ago ) about two weeks after he started Zyban. Somehow it discouraged quite a few people to use it.

The Canuck

P.S. Apparently they are working on something much better with lesser side effect, and more efficient too.

I started it when I first got to NZ...did'nt smoke for 3 months...piled on 7 kilo's, then I worked out that it would cost less to smoke than it would to restock my wardrobe... ..I'm not a really heavy smoker and I enjoy the one's I have, it hepls me to relax.

If you can get hold of ZYBAN then that is the easiest way to give up...no withdrawals and no cravings.

Hi Canuck...There are a few problems associated with the drug...like many other drugs on the market..people with heart problems should stay away from it ..the only other side effect I have heard about from a few people (it didn't happen to me) is chronic constiaption, and I have been told it causes quite sever pain...also if you come out in a rash stop it ASAP...but I have heard more positive results than negative results.

FYI.. Zyban and Wellbutrin and the same thing... bupropion. Just marketed under different names for different purposes. They will tell you not to take one if you are taking the other because you would be overdosing yourself on it.

My cousin used Zyban. It worked for her, but she claimed the side effects she experienced were bad headaches and it made her a total bitch. Well, we didn't notice the difference because she's always been a total bitch and thus we were rather glad she got bad headaches.

wellbutrin is officially an antidepressant.... but it has the side effect of reducing or eliminating the craving to smoke... it is not approved in the us for that purpose i believe but many people take it for that specific reason.;

I was on Wellbutrin for a bit and it made me stop drinking coffee and espresso, which I drank tons everyday as it helped with the ADHD. I had no craving for coffee and the thought of it repulsed me while on it. I wonder if living in a very secluded area whose closest Starbucks was an hour away had anything to do with it? Science is so confusing.Duuude

I was reading something that claimed that smoking lowers your CD4s, but there weren't any studies mentioned or numbers to back it up. I know a doctor would be a bit biased on the subject - not that I don't trust him, he's great. Do any of you know if that statement is true - tobacco lowering CD4s as well?

I read a study that claimed it did for HIV-negative people. If I get time tomorrow I'll look it up. I think the other thing is that smoking is bad for is OI's of the mouth and lungs - it's a problem for people without HIV, so I think the extension is that it would be worse for people with HIV.

However, the study I read was for HIV-negative men and I don't know that it translates to HIV. The bottom line of your question is "Does smoking speed the progression of HIV to AIDS and affect health" The answer to that question requires a bit of searching because it might not be simple enough to look at the CD4/smoking studies and say that it is bad for people with HIV. I'll look for a study that answers the question above about health and progression to AIDS, because the whole CD4 decrease in smokers might not be significant in HIV positive people.

R

« Last Edit: June 01, 2006, 11:30:50 PM by HIVworker »

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NB. Any advice about HIV is given in addition to your own medical advice and not intended to replace it. You should never make clinical decisions based on what anyone says on the internet but rather check with your ID doctor first. Discussions from the internet are just that - Discussions. They may give you food for thought, but they should not direct you to do anything but fuel discussion.

I stopped smoking three years ago after having tried to stop for two years. But in the last 9 years my cd4's have only gone up until they started to remain constant last september. I have more oxygen now and les upper repiratory infections, but I dont see any influence of smoking or non smokingon my cd4's, although my study is based on a sample of one; myself.

I've taken Zyban twice to quit smoking and it did not work either time. The dose is one 150 mg tablet for the first few days then you up the dosage to 2 150 mg tablets, one taken twice a day.Zyban is the same as Wellbutrin, just marketed under a different name, when used for the different purposes.

First time I took the full 90 day course but started smoking again as soon as I stopped. Second time round it had minimal effect if any on my desire to smoke.

I hope you see the irony in your question MoltenStorm. The effect of smoking on your CD4 count will be of littlle consequence once you drop dead from heart disease, cancer, emphysemia (sp) or lose a limb or two from gangrene etc etc. Smoking kills 50% of long term smokers. Why anyone would smoke is beyond me, why anyone with HIV smokes beggars belief.Now leave me alone while I go and ejoy a cancer stick. I'll be back in 5.

Why anyone would smoke is beyond me, why anyone with HIV smokes beggars belief.Now leave me alone while I go and ejoy a cancer stick. I'll be back in 5.

*rolling in laughter*

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"Love is always patient and kind. It is never jealous. Love is never boastful nor conceited. It is never rude or selfish. It does not take offense and is not resentful. Love takes no pleasure in other people's sins, but delights in the truth. It is always ready to excuse, to trust, to hope, and to endure whatever comes." - 1 Corinthians 13:4-7, adaptation in A Walk To Remember

My doctor says that people with impaired immune systems (poz boys and girls) have a higher risk of lung cancer. I respect my doctor and his opinion a lot, he may be right, but, in reality, I smoke, I am not really planning on quitting any time soon. So, my response to him is, "i really have more pressing matters to deal with"

Note that "preliminary studies indicate that gay men and lesbians tend to smoke more than their heterosexual counterparts. Several small studies show that smoking rates among gays and lesbians are high and increasing rapidly," says "Tobacco Use and Lesbian, Gay, Bisexual and Transgender (LGBT) Populations" (1998).

"smoking rates are higher among adolescent and adult lesbians, gays, and bisexuals than in the general population," says American Journal of Preventive Medicine (2001).

For example, "Gay men and lesbians in California are 70 percent more likely to smoke than the general population, according to a recent UCLA study," says "NPR: Anti-Smoking Campaign Targets Gays" (22 July 2003).

"The percentage of young gays and lesbians who smoke is nearly double the national average among teens," says "Smoking By Young Gays At 'Alarming' Level" (26 October 2004).

"There were consistent patterns of elevated drug use in homosexually experienced individuals for life-time drug use, but these were greatly attenuated for recent use. Homosexually experienced men were more likely to report use of marijuana, cocaine and heroin, and homosexually experienced women more likely to report use of marijuana and analgesics than individuals reporting only opposite-sex partners. Both homosexually active men and women were more likely than exclusively heterosexually active respondents to report at least one symptom indicating dysfunctional drug use across all drug classes, and to meet criteria for marijuana dependence syndrome," say S. D. Cochran SD, D Ackerman, V. M. Mays, and M. W. Ross, "Prevalence of non-medical drug use and dependence among homosexually active men and women in the US population," 99 Addiction (#8) 989-998 (2004).

"Smoke-filled bars and clubs are common hang outs for some gay men. For this reason, according to the American Cancer Society, gay men are more likely to smoke or be exposed to smoke. A recent gay.com article on gay smoking cites 36 percent of LGBT adults are smokers, compared with 25 percent of all adults. Smoking accelerates the progression of AIDS and increases the risk of lung cancer. HIV also accelerates smoking-induced emphysema," says Ramon Johnson, "Gay Smoking and Cancer: Gays Have Higher Cancer Risk" (2006).

Cigarettes' toxic chemicals impair the immune system. The underlying fact about tobacco smoke is that its massive quantities of toxic chemicals cause

"mutations of cellular genetic structures, deviation of cellular characteristics from their optimal normal state [leading to] a body-wide spectrum of disease,"—R. T. Ravenholt, M.D., M.P.H., writing in 307 New Engl Journal of Med (#5) 312 (29 July 1982). "Loss of activation of [normality] leads to a variety of immunologic disorders characterized by autoimmunity or immunodeficiency . . . Major immunologic abnormalities result from alterations in the mature T-cell subsets."—Ellis L. Reinherz, M.D. and Stuart F. Schlossman, M.D., "Regulation of the Immune Response--Inducer and Suppressor T-Lymphocyte Subsets in Human Beings," 303 New Engl J of Med 370-373 (14 Aug 1980).

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"Love is always patient and kind. It is never jealous. Love is never boastful nor conceited. It is never rude or selfish. It does not take offense and is not resentful. Love takes no pleasure in other people's sins, but delights in the truth. It is always ready to excuse, to trust, to hope, and to endure whatever comes." - 1 Corinthians 13:4-7, adaptation in A Walk To Remember

"Love is always patient and kind. It is never jealous. Love is never boastful nor conceited. It is never rude or selfish. It does not take offense and is not resentful. Love takes no pleasure in other people's sins, but delights in the truth. It is always ready to excuse, to trust, to hope, and to endure whatever comes." - 1 Corinthians 13:4-7, adaptation in A Walk To Remember

Interesting insurance fact- years ago when i tried to quit smoking my insurance would not cover Zyban. Seems they thought it was "elective" or maybe their accountants hadn't figured out that a few hundred dollars now might save many thousands in lung cancer treatment. My doc just called them idiots and prescribed Wellbutrin at the same dosage. I know that they changed the policy a few years later.

A year ago my entire life was heading down the toilet and I picked up the nasty habit again. My CD4s have also slid significantly, but I was really depressed this year, too. I haven't been eating right, been drinking more, been working myself like a dog- probably all of that has contributed to my health change.

OK, I have avoided posting anything regarding smoking because, frankly, I'm a bit ashamed. I quit several months back. I was doing OK, aside from discovering the trying to use nicotine patches that had expired in the last century didn't work.

But, I'm afraid it didn't last. It was a costing me more in groceries than I could afford. Yes, I started again.

I have smoked for 30 years. I rarely drink, don't drug, have fond memories of sex, don't eat anything containing wheat, oats or barley, and don't consume most dairy products.

Somehow, though, giving up cigarettes, and the occasional cigar, is something I have been unable to do. When I walk into the tobacconists, the aroma is just so intoxicating, I nearly orgasm.

Having Chronic Emphysema helps in quitting. Especially when you have stairs to go up and down.

I quite over four years ago. I can breath much better. (Working on only 30% of total lung capacity) and most everything smells a lot nicer. Except for when a smoker passes on the sidewalk and you get a whiff. Even the hottest looking person all of a sudden, well YUK!

My numbers have remained the same. No improvement. But my numbers have always been good; it’s just my health that sucks.

And I don’t buy into the theory that cigarettes lead into other drug use. I’ve never done recreational drugs. But have gotten a world of knowledge on recreational drugs right here at AIDSmeds.

It's actually hard to find a good study on smoking and CD4 counts. Pretty much all of them are done in HIV-negative people and the data extrapolated to HIV positive people. Sort of to say, "Well, it does this in HIV negative people, therefore it can't be good in HIV-positive people."

The correct study would be in HIV-positive people only and to compare the results to HIV negative people. One report did mention that there was no increase morbidity between smokers and non-smokers with HIV, but this was quite old (1991) so we have to add a note of caution. To truly answer this question requires a MODERN study. Old studies were done in a time when HIV life-expectancy was lower and the impact of smoking might have been masked by the disease itself. However, with HAART and now knowing methods of looking after your body, the impact smoking might have on the quality of the immune system might rise above the noise.

To specifically answer your question though, there is a drop in CD4 cells when you smoke, but this is not any more significant than in people who don't have HIV. That isn't to say it isn't a bad thing, because as DingoBoi mentions, if it is a 10% drop this is going to have more of an impact the lower the starting CD4 count. If you read the literature, there doesn't seem to be much of a consensus. Some say smoking does nothing to CD4 counts, some say decrease, some say increase.

I think it is understandable that doctors would not advocate smoking in HIV positive people, given the potential effects on the immune system and increase risks of acquiring lung cancer and many other respiratory OI's. More recent studies such as this one...

..paint a rather bleak picture of HIV and smoking. The effect on CD4 counts? The jury is out. The effect on your health? The data indicate a negative impact.

NB. Any advice about HIV is given in addition to your own medical advice and not intended to replace it. You should never make clinical decisions based on what anyone says on the internet but rather check with your ID doctor first. Discussions from the internet are just that - Discussions. They may give you food for thought, but they should not direct you to do anything but fuel discussion.

A dear friend of mine quit smoking two years ago and has done very well...though clearly his weigh gain was a direct result. Last year he had open heart surgery and his doctor commended him on having quit as a positivefactor in his recovery. Personally I still smoke and maybe one day I'll have toquit but for now its one of the only things that keeps me sane...

The claim that smoking could lead to other drugs reminds me of high school whenteachers insisted that smoking pot could lead to harder drugs... I didn't buy it thenand I don't believe smoking cigarettes is going to make me want to do coke or heroinenow.

As a addict (coke & alcohol being my drugs of choice) When it came to smoking potI could take it or leave it. Being gay and living the life most of us do/did, drugs and alcoholwere usually a big part of whatever I did. Now I drink maybe a glass of wine a day....andoccassionally take a couple of puffs on a joint.

I'd be more inclined to believe that being GAY leads to drug and alcohol abuse ...wonder if there are any studies on that one.

I'd be more inclined to believe that being GAY leads to drug and alcohol abuse ...wonder if there are any studies on that one.

Interesting. Well, I would say from my dating experience and from bar observations, there is a lot of alcohol and drug use/abuse in the gay community. A number of years ago I started getting treated for depression with SSRIs and talk-therapy. I was really resistant to the idea- gave the standard excuses, "I'm a man, I don't need pills" and, "I'm not crazy"..... well my doc told be that his practice is probably 85% gay and half of his patients are probably being treated for depression and/or anxiety. He also said that when he goes to the American Medical Assn meetings, most doctors with predominately gay practices have similar experiences. I asked him why and in his charming southern Georgia accent he said, "Well let's see we all hid in the closet for 15-50 years terrified that we'd be thrown out, disowned, beat-up or killed if anyone found out. That kind of upbringing would make anyone a little depressed or anxious."

I am sorta an Addict Lite- only cigarettes for me. But I do think that I've used them to self-medicate when needed. A little prozac in a stick with the lovely side-affect of smelly clothes and cancer.

The difference between Wellbutrin and Zyban: RX for Wellbutrin is covered on most insurance plans and Zyban is not ( but they are they same thing ).

I think I could smoke less if the Brits didn't call them fags. That alone makes me want one.

There are "Stop Smoking" Clinics that give you shots behind your ears. This really does work if the person wants to quit. I stopped for 6 months with this before picking the habit back up - just had to suck on a fag.

i have a major med plan and it's 'covered' but only under 'step therapy' for depression. meaning i have to be crazier than i am to take it essentially.... lexapro works pretty well... for mood.. but causes other issues.... zyban is often disallowed by MOST US prescription plans....wellbutrin is only allowed in step therapy in MOST prescription plans... yes, same drug... but very hard to get.... the insurance companies don't want us taking this. they don't get the concept that an ounce of prevention prevents a pound of CLAIMS later.

i think this is a very good thread. i hide behind the shield of only smoking 3 cigs a day. 1 on the way to work1 on the way home, 1 after dinner and ice cream. i've held this regimin for the last 5/6 years. UNLESS i drink.then...its kattie bar the door. I just have'nt been able to shake it. 2 individual smokes per day........you'd think one could kick that???~jordon

jordan, i don't think that's really a habit.... it normal terms... i see zero reason to give it up if you enjoy it an it brings something to you.... if you said you were smoking 2 packs a day... well.. cutting down is good... but only a few a day? Zero is best but also weigh the pleasure/relief it brings you... a couple a day ISN'T going to do anything severe at all.... keep on smokin em if you enjoy it.... if you want to give it up completely, you are well far along than most of us who smoke a pack a day or more.

"The investigators also looked at the effect of tobacco smoking, and found that “tobacco smoking was associated with approximately 6% (p < 0.01) and 7% increase (p = 0.04) in mean CD4 cell count in HIV-uninfected and HIV-infected men.”

I took Chantix in 2007-08 and was able to quit...for awhile. It blocks the nicotine receptors in the brain...different physiological approach than other treatments. Of course, you have to want to quit, and no drug can induce that desire. I quit for six months, then started again due to stress. My CD4s are in the 800s. When I'm ready again some day, I'll go back on Chantix. Problem is I love smoking.